Department of Breast Surgery, The Tumor Affiliated Hospital of Harbin Medical University, 150 Haping Road, Harbin, 150086, Heilongjiang, China.
Department of In-Patient Ultrasound, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang, China.
Clin Transl Oncol. 2020 Jan;22(1):91-102. doi: 10.1007/s12094-019-02112-z. Epub 2019 Apr 20.
Breast ultrasound and mammography were used in the detection of residual tumor after neoadjuvant chemotherapy. The aim of this study was to evaluate the correlation between clinical and pathological responses with breast density and IHC marker conversion to understand how this information might be used in the future to direct treatment.
We included 119 patients who underwent CNB and followed NACT. The breast density assessment was based on the mammography examination performed at the time of diagnosis. We evaluated the clinical and pathological responses to NACT by the UICC and Miller-Payne grading systems, respectively.
Of 119 patients who met the inclusion criteria, patients with high pre-treatment IHC markers levels showed higher expression of IHC markers regardless of the post-treatment IHC marker level at baseline. However, breast and node tumor sizes before and after NACT were negatively correlated with hormone receptor conversion and positively correlated with Ki-67 conversion (P < 0.05). Patients with low BD were more likely to have a cCR, pCR, TNBC, and postmenopausal status than those with a high BD (P < 0.05). BD was significantly associated with PR and Ki67 conversion but not ER conversion.
Our prospective observational study demonstrated that IHC marker conversion could be used to identify lesion size changes and BD. We also found that a high BD was linked to clinical and pathological responses, molecular subtype, and menopausal status. In the future, additional studies are required to validate the predictive value identified by this research.
乳腺超声和乳腺 X 线摄影用于检测新辅助化疗后的残留肿瘤。本研究旨在评估临床和病理反应与乳腺密度和免疫组织化学（IHC）标志物转化之间的相关性，以了解未来如何利用这些信息来指导治疗。
我们纳入了 119 例接受了核心针活检（CNB）并接受新辅助化疗（NACT）的患者。乳腺密度评估基于诊断时进行的乳腺 X 线摄影检查。我们分别采用 UICC 和 Miller-Payne 分级系统评估 NACT 的临床和病理反应。
在符合纳入标准的 119 例患者中，高治疗前 IHC 标志物水平的患者在基线时无论治疗后 IHC 标志物水平如何，均表现出更高的 IHC 标志物表达。然而，NACT 前后的乳腺和淋巴结肿瘤大小与激素受体转化呈负相关，与 Ki-67 转化呈正相关（P<0.05）。与高 BD 相比，BD 低的患者更有可能获得完全缓解（cCR）、病理完全缓解（pCR）、三阴性乳腺癌（TNBC）和绝经后状态（P<0.05）。BD 与 PR 和 Ki67 转化显著相关，但与 ER 转化无关。
我们的前瞻性观察性研究表明，IHC 标志物转化可用于识别病变大小变化和乳腺密度。我们还发现，高 BD 与临床和病理反应、分子亚型和绝经状态相关。未来需要进一步的研究来验证本研究确定的预测价值。
